G0426
HCPCS Procedure Code
HCPCS code G0426 is the #4,577 most-billed Medicaid procedure code, with $506K in payments across 13K claims from 2018–2024. The national median cost per claim is $36.25. Costs vary widely — the 90th percentile is $91.70 per claim, 2.5× the median.
Total Paid
$506K
0.00% of all spending
Total Claims
13K
Providers
79
Avg Cost/Claim
$40
National Cost Distribution
How much do providers bill per claim for G0426? Based on 67 providers billing this code nationally.
Median
$36.25
Average
$42.13
Std Dev
$36.54
Max
$135.99
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.87 and $61.49 per claim for this code.
90% bill between $3.61 and $91.70.
Top 1% bill above $135.49.
About This Procedure
HCPCS code G0426 was billed by 79 providers across 13K claims, totaling $506K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$36.25
Providers Billing
67
National Spending
$506K
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for G0426
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1871955807 | $202K |
| 2 | 1790286193 | $63K |
| 3 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $43K |
| 4 | 1548366263 | $35K |
| 5 | Legacy Clinics Llc Portland, OR | $17K |
| 6 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $13K |
| 7 | 1083036651 | $11K |
| 8 | 1447334750 | $9K |
| 9 | 1649604661 | $8K |
| 10 | 1346301306 | $8K |
| 11 | 1982799086 | $7K |
| 12 | 1396739165 | $7K |
| 13 | 1740595917 | $7K |
| 14 | 1093779704 | $6K |
| 15 | 1922145606 | $6K |
| 16 | 1851884548 | $5K |
| 17 | 1053343004 | $5K |
| 18 | 1013303080 | $5K |
| 19 | 1245278209 | $4K |
| 20 | 1669835310 | $4K |
Showing top 20 of 79 providers billing this code